After continued blatant disregard for the Quality of Care Corporate Integrity, consistent failures of inspections, a 1500 page bi-partisan 2012 Congressional Report and various warnings by HHS-OIG, CSHM, LLC received notice they were Excluded from the Medicaid program in March 2014. However the government saw fit to allow CSHM, LLC to pilfer and plunder the Medicaid slush fund for an additional 6 months under an Exclusion Agreement.

“This exclusion marks the culmination of a series of alleged failures by CSHM and its corporate predecessors to comply with its CIA. Under the CIA, an independent quality monitor conducted more than 90 site visits and reviews to monitor CSHM's compliance. Since the 2010 settlement, OIG repeatedly cited CSHM and took actions to address those violations, promote improved compliance, and maintain access to care for an underserved population. These actions included imposing financial penalties and forcing the divestiture of one of the company's clinics.

Despite these actions, CSHM remained in material breach of its CIA and OIG issued Notices of Intent to Exclude to the company in December 2013 and January 2014. In such cases, providers have the opportunity to demonstrate to OIG that they have cured, or are in the process of curing, the material breaches. CSHM represented to OIG that it would cure the material breaches. However, through meetings with CSHM and its Board of Directors and review of its written submissions, OIG determined that CSHM had failed to cure the material breaches and proceeded with the exclusion.

Until the exclusion goes into effect on September 30, 2014, an independent monitor will continue to monitor the quality of care being provided to patients at CSHM clinics. CSHM is required to inform patients at least 30 days before closing a clinic. CSHM is also required to keep State Medicaid agencies abreast of developments and provide monthly status reports to OIG. Any divestiture of assets by CSHM must be through bona fide, arms-length transactions to an entity that is not related to or affiliated with CSHM.”

Here we are in 2015, 8 years since Small Smiles dental centers and their so called management company, CSHM were first investigated—it started in mid 2007— and it just past the anniversary of the 5 year CIA. Heck it expired two weeks ago—January 15, 2015.
According to the 31 page, 3 columns, list of Creditors filed February 5, 2015 they still owe various states their portion of the $24 million dollars. (a breakdown is below)

They owe several “owner dentists”, support staff, and other dentists, as well as whistleblowers, dental boards, ad agencies, law firms, TV stations, court reporters, (for the numerous lawsuits in which they are involved), storage facilities,(wonder what’s hidden there), utility bills for their clinics, dental labs and insurance companies (hope they kept the Malpractice premiums up for all those dentists!), and every dental supply company in the country, and various management companies. (yep, the management company hires management companies)

Other notables were, Garrison Loan Agency who ponied up the dough to keep this scumbag company alive and kicking from 2012-2015 and the IRS.

Those missing for the list are David R. Wilson, CEO and other top executives, and Waller Landsden Law Group. Hmmm… Pleadings indicate Wilson was paid $1,194,432.85 the year preceding the filing of the bankruptcy.

Other points of Interest in the initial documents:Doc 2 Schedules of Assets and Liabilities,
Page 2, Item 3
—In accordance with the Exclusion Agreement, the Company divested itself of substantially all of the CSHM Assets through a series of sales between April and September 2014. Included among the sale of the CSHM Assets, the Company sold certain assets to First Quality Management, Inc. (FQMI), pursuant that certain Asset Purchase Agreement, dated as of September 30, 2014. Separately, the Company also entered into that certain Assignment and Assumption Agreement with FQMI, dated September 30, 2014, in connection with the assumption of six (six) MSA’s. A breakdown of the other clinics can be found here, beginning on page 9. Missing from that list is all the Colorado clinics except the Colorado Springs clinic. Interesting, indeed.

The 2010 Corporate Integrity AgreementThe DOJ said in 2010 “"We have zero tolerance for those who break the law to exploit needy children," said Tony West, Assistant Attorney General for the Civil Division of the Department of Justice. "Illegal conduct like this endangers a child’s well-being, distorts the judgments of health care professionals, and puts corporate profits ahead of patient safety."

(cough, choke and puke, they have complete tolerance, encourage it, and are accomplices to it!)

"Dentists have been fired, clinics have been closed, and this is not the same company," Lisa Re, a branch chief and attorney with the agency, said at the time. “CSHM is improving since it emerged from bankruptcy in June 2012 with a new CEO and leadership.”

“I would say that it is getting much better."

"The company as it operates today is simply not the same as the company that was repeatedly violating the agreement,"

"Some of the states were alarmed that we were even considering closing any of the clinics …”

A five year CIA with FORBA (f/k/a Church Street Health Management f/k/a FORBA) beginning in January 2010 netted:

Negative $26 million dollars. ( I call for those in charge to head back over to Congress and report they failed to collect $24 million, since they trotted over in 2010 to report they had “recovered” it. They actually called it “Significant Work”. (laughable, I knew it then and it’s been proved over and over) I also call on each and every state Attorney General who sent out press releases boasting about their portion of the negotiated settlement to issue a “correction”.

Thousands of hours wasted by government employees. (Taxpayer dollars pay those wages too)

5 Million babies and children subjected to mistreatment and mangled mouths. (They see about 1 million children a year)

$800 million or more dollars in the pockets of the bad guys. ($168M a year, based on 2011 billing; current Pleadings say they gross income was $116,446,137.00 in 2013.)